Healthcare Provider Details

I. General information

NPI: 1699638338
Provider Name (Legal Business Name): TANEIKA L MOSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18331 MARGARETA ST
DETROIT MI
48219-2916
US

IV. Provider business mailing address

18975 APPOLINE ST
DETROIT MI
48235-1318
US

V. Phone/Fax

Practice location:
  • Phone: 313-659-8219
  • Fax:
Mailing address:
  • Phone: 248-242-2042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: